Cholesterol is a waxy substance that works in the body to help support cell membranes, manufacture hormones, aid in digestion, and convert vitamin D in the skin.
A person with high cholesterol should follow a heart-healthy diet. The DASH (Dietary Approaches to Stop Hypertension) eating plan promoted by the National Heart, Lung, and Blood Institute is considered a heart-healthy approach.
9 Foods to Eat to Lower Cholesterol
The DASH eating plan does not require any special foods but there are daily and weekly nutritional goals. The DASH plan recommends:
- Vegetables
- Fruits
- Whole grains
- Beans
- Nuts
- Fat-free or low-fat dairy products
- Fish
- Poultry
- Non-tropical vegetable oils
11 Foods to Avoid with High Cholesterol
The DASH eating plan also recommends avoiding or limiting foods such as:
- Foods high in saturated fat
- Fatty meats
- Full fat dairy products
- Tropical oils such as coconut, palm kernel, and palm oils
- Processed meats
- Red meat
- Egg yolks
- Fried foods
- Many fast foods and frozen foods (also often high in sodium)
- Sugar-sweetened foods
- Sugar-sweetened beverages
- Salty foods (foods high in sodium)
The American Heart Association recommends limiting saturated fat in the diet to less than 6% of daily calories and minimizing consumption of trans fats.
How to Lower Cholesterol Naturally (and with Medication)
In addition to a heart-healthy diet, treatments for high cholesterol include:
- Lifestyle changes
- Exercise regularly
- Don’t smoke or vape
- Lose weight if you are overweight
- Medications
- Statins (HMG CoA reductase inhibitors)
- Ezetimibe (cholesterol absorption inhibitors)
- Bile acid sequestrants (also called bile acid-binding agents)
- PCSK9 inhibitors to lower LDL (bad) cholesterol
- Adenosine triphosphate-citrate lyase (ACL) inhibitors
- Fibrates
- Niacin (nicotinic acid), a B vitamin
- Omega-3 fatty acid ethyl esters
- Marine-derived omega-3 polyunsaturated fatty acids (PUFA)
What Are Symptoms of High Cholesterol?
High cholesterol usually has no symptoms. It is detected with a blood test.
What Causes High Cholesterol?
The body naturally produces cholesterol in the liver, which makes up about 75% of the cholesterol in the body. For most people, high cholesterol levels come from foods we eat and an unhealthy lifestyle.
Lifestyle factors that can negatively affect cholesterol levels include:
- Unhealthy diet
- Sedentary lifestyle
- Being overweight or obese
- Smoking, exposure to secondhand smoke, or vaping
High cholesterol may also be genetic in some cases. Familial hypercholesterolemia (FH) runs in families and increases the risk for premature atherosclerotic heart disease.
How Is High Cholesterol Diagnosed?
The American Heart Association recommends adults 20 years and older have their cholesterol levels checked every four to six years.
Cholesterol levels are checked with a blood test, which may be a “fasting” or “non-fasting” lipoprotein profile. A fasting test usually means not eating, drinking certain beverages, or taking medications between 9 and 12 hours before the cholesterol test.
People who do not have heart disease should aim for the following cholesterol levels:
- Total cholesterol below 200 mg/dL
- Levels above 200 mg/dL are considered high and mean a higher risk for developing heart disease
- LDL cholesterol (“bad” cholesterol) below 130 mg/dL
- Or much lower for those at risk of heart attacks or stroke
- Too much LDL can build up in the artery walls and form plaque that narrows arteries and restricts blood flow, which lead to coronary artery disease
- High levels of LDL cholesterol mean a person has an increased risk of stroke and heart attack
- HDL cholesterol (“good” cholesterol) above 60 mg/dL
- HDL levels of 60 mg/dL and higher can help reduce the risk for heart disease
- HDL levels of 40 mg/dL and lower are considered a risk factor for developing heart disease
- HDL removes LDL cholesterol from the bloodstream and the artery walls
- A higher HDL score is desirable
- Triglycerides (a form of fat in the body) below 150 mg/dL
- Levels higher than 150 mg/dL increase the risk of developing heart disease and metabolic syndrome, which is also a risk factor for heart disease, diabetes, and stroke
- A high triglyceride level can mean a higher risk of developing coronary artery disease
- Non-HDL cholesterol below 160 mg/dL
- This is the total cholesterol minus the HDL cholesterol
- Or lower for those at risk of heart attacks or stroke
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https://www.heart.org/
https://www.uptodate.com/contents/high-cholesterol-the-basics?search=cholesterol&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.nhlbi.nih.gov/health-topics/dash-eating-plan